Application of low energy heat
Medicare pricing data for 468 providers across 10 states
This procedure has a 5.6x markup — hospitals charge $27.84 but Medicare allows only $4.96. Uninsured patients may face bills 5.6 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Application of low energy heat (HCPCS code 97026) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.96, but hospitals typically charge $27.84 — a 5.6x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.96, your out-of-pocket cost would be approximately $0.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.6x more than what Medicare allows for this procedure. Medicare actually pays $3.86 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Wyoming | $5 | $20 | 17 | 156 | +9.3% |
| California | $5 | $29 | 292 | 20,371 | +3.6% |
| Oregon | $5 | $33 | 13 | 176 | -6.5% |
| Nevada | $5 | $27 | 9 | 316 | -9.1% |
| Arizona | $4 | $32 | 36 | 1,088 | -9.9% |
| Washington | $4 | $16 | 29 | 1,077 | -10.1% |
| South Dakota | $4 | $31 | 10 | 341 | -14.3% |
| Utah | $4 | $20 | 10 | 2,084 | -15.1% |
| Idaho | $4 | $20 | 20 | 403 | -20.0% |
| New Jersey | $4 | $47 | 2 | 142 | -23.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber